Individual provider Active NPI

Tsipora Rubinov, DDS

  • Dentist
  • Elmhurst, NY
National Provider Identifier
1710978093
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
047292 Issued in NY
Practice address
9442 58TH Ave
Unite G-2 Prestige Dental
Elmhurst, NY 11373-5149
Phone
(718) 699-4660
Fax
(718) 699-4694
NPI assigned
Nov 4, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 047292 NY Primary

Addresses

Primary practice location

9442 58TH Ave
Unite G-2 Prestige Dental
Elmhurst, NY 11373-5149

Mailing address

9442 58TH Ave
Unit G-2 Dr Tsipora Rubinov
Elmhurst, NY 11373-5149
Phone (718) 699-4660

Other identifiers 1

IdentifierTypeStateIssuer
01792910MedicaidNY

Other names 1

  • Tsipora Abdurakhmanova Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160323000728 NY Order and Referring Only - DentistPractitioner - Dentist 5092012856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Asher Rubinov Dental LLC Dentist PastSince Feb 23, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710978093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9442 58TH AVE",
            "address_2": "UNIT G-2 DR TSIPORA RUBINOV",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735149",
            "telephone_number": "718-699-4660",
            "fax_number": "718-699-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9442 58TH AVE",
            "address_2": "UNITE G-2 PRESTIGE DENTAL",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735149",
            "telephone_number": "718-699-4660",
            "fax_number": "718-699-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBINOV",
        "first_name": "TSIPORA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "047292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01792910",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TSIPORA",
            "last_name": "ABDURAKHMANOVA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.